Overview In this role you lead OHA's statewide program integrity and Medicaid compliance efforts, supervising a multidisciplinary team to prevent fraud, waste, and abuse. You collaborate with federal and state partners to advance policy, guidance, and performance objectives that safeguard public resources. You'll drive data-informed investigations, audits, and provider oversight while advancing health equity. This is a high-impact, strategic position at the intersection of policy, operations, and compliance.
Compensation / Benefits- low-cost medical, vision, dental coverage
- life insurance and disability options
- PERS/OPSRP retirement
- generous paid time off and holidays
- Public Service Loan Forgiveness eligibility
- training and career development opportunities
Responsibilities- Set priorities and develop policies for program integrity, fraud, waste, and abuse (FWA) and Medicaid compliance
- Lead a multidisciplinary team responsible for investigations, audits, data analytics, and provider oversight
- Oversee budget, contracts, staffing, strategic planning, and performance management for OPI
- Represent OHA in external committees, liaison with CMS and other agencies, and provide guidance to leadership on Medicaid compliance and program integrity
- Identify emerging risks and trends, strengthen detection/investigation strategies, and use data to improve program integrity
- Promote health equity and ensure transparent, accountable stewardship of Medicaid funds
- Collaborate with internal teams and external partners to deliver technical assistance and education on compliance and program integrity
- Manage complex portfolio within OHA's $21 billion annual operation and exercise independent decision-making authority
Key requirements- Five years of management experience; OR two years of management experience and a bachelor's degree in a related field
- Desirable: seven+ years of management experience
- Bachelor's degree with a master's degree preferred
- Demonstrated knowledge in fraud investigation, program integrity, regulatory compliance, and related legal/administrative proceedings; experience with court or formal proceedings, negotiations, and communicating complex issues to executives and regulators
- Executive communication and stakeholder engagement
- Strategic leadership and cross-functional collaboration
- Analytical mindset with data-driven decision making
- Medicaid program integrity and regulatory compliance
- Fraud, waste and abuse investigation and oversight
- Audits and risk assessments
